In order to best protect confidential and other important data, the ODJFS website will no longer support several outdated web browsers. Effective December 5, Internet Explorer 6 or older, Opera 4 or older and Netscape Navigator will no longer work on ODJFS sites that are https-enabled. Individuals can download the most recent version of Internet Explorer here and the most recent version of Opera here.

In order to best protect confidential and other important data, the ODJFS website will no longer support several outdated web browsers. Effective December 5, Internet Explorer 6 or older, Opera 4 or older and Netscape Navigator will no longer work on ODJFS sites that are https-enabled. Individuals can download the most recent version of Internet Explorer here and the most recent version of Opera here.

1. Where do I return requested verifications or paper work? [Top]Applications, verifications, and any other paper work can be submitted in person, by mail, or by fax at your local county agency. (http://jfs.ohio.gov/county/cntydir.stm)

3. How can I receive verification of my current case status?[Top]You may review or print your benefit history (http://odjfsbenefits.ohio.gov/) within "My Case". You may also contact your county agency to request this information.

4. How can I get a form or notice sent to me?[Top]Within "My Case", you may view or print a list of notices (http://odjfsbenefits.ohio.gov/), which are listed in "My Case." If you do not see the notice you are looking for, please contact your county agency. You may also view or print the most commonly used forms (http://odjfsbenefits.ohio.gov/). which are listed in "My Case." If you do not see the form you are looking for, please contact your county agency.

6.Do all health care providers accept Medicaid?[Top]Not all health care providers accept the Medicaid card. You should find out if a healthcare provider accepts Medicaid before you make an appointment. If you are enrolled in a managed care plan you must choose a provider that accepts that plan.

7.How long does it take to process my paper work?[Top]The county agency has 30 days to process your application.If your household meets the necessary criteria you may be eligible to receive food benefits faster. Who is eligible to receive benefits faster? - If your net income after taxes and expense deductions, such as housing costs, child care costs or child support cost for the current month is zero; - If your liquid resources are one hundred dollars or less; (cash, checking account, saving account, etc.) - If you have less than one hundred fifty dollars in gross monthly income; - If you are a seasonal farm worker; or - If your combined monthly gross income and liquid resources are less than your monthly rent or mortgage and utility expenses.If you do not have a decision on your application after 30 days you may want to contact your county agency.

8.When will I get my monthly Food Assistance benefits? [Top]If you are currently in receipt of Food Assistance you can find this information under “My Case” under the “Your Benefits" tab. If you have applied for Food Assistance and are approved, the estimated receipt date will also be on your approval notice.

9. Who do I need to list on my application?[Top]On your application include yourself and everyone living with you, even if they are not applying for benefits for themselves. If you are applying just for your child, also include yourself.

10. What are the necessary verifications for Food Assistance, Cash and Medicaid? [Top]The table below lists the items required for each program you are applying for. Contact your local county department of job and family services for examples of the documents you can use as proof. If you can't bring everything, come to the interview anyway and we will help you.- If you are not a U.S. citizen and are only applying for alien emergency medical assistance, you do not have to verify your citizenship status or immigration status, or provide a social security number.- Your food assistance amount may increase if you also bring proof of the following costs: child/dependent care, child support paid for children not living with you, housing, utilities, medical costs for people with disabilities or for people who are over age 60 (including prescriptions).

CashAssistance

Food Assistance

MedicalAssistanceFamilies and children

MedicalAssistanceAged, blind orDisabled

Proof you have applied for a Social Security Number(if you don't already have one)

x

x

x

x

Permanent Resident Card ("green card") or other INS documentation if not a U.S. citizen

x

x

x

x

Proof of U.S. citizenship if a U.S. citizen

x

x

x

Proof of income or any other money coming into your household (such as pay stubs, tax records, award letters, child support)

x

x

x

x

Most recent statements for any bank accounts (such as checking, credit union, savings)

Proof of current value of stocks/bonds, certificates of deposit, life insurance, trusts, annuities

x

x

x

Proof of identity

x

x

Proof of any child/dependent care costs

x

x

x

Proof of any child support paid for children not living with you

x

x

x

Proof of any housing and utility costs

x

Proof of any medical costs for people with disabilities or for people who are over age 60 (including prescriptions)

x

x

Proof of any health insurance

x

x

11.How do I request a state hearing?[Top]A state hearing can be requested a variety of ways. You may request a hearing by:1. Fax: To the Bureau of State Hearings at 614-728-95742. E-mail: BSH@jfs.ohio.gov3. Telephone: 1-866-635-3748, option 1. 4. Mail: State Hearings Ohio Department of Job and Family Services P.O. Box 182825, Columbus, Ohio 432185. The county agency sends out a notice if it is going to lower or stop the benefits you get. You can use this notice to ask for a state hearing. The notice tells you how to ask for a state hearing by filling out the notice and sending it in. Check the mailing date on the notice. You must ask for a hearing within 90 days of that mailing date.IF your benefits are being lowered or stopped, AND you ask for a hearing within 15 days of the mailing date of the notice, THEN your benefits will stay at the old amount until your hearing is decided.However, Food Assistance may not continue if it is the end of your Food Assistance certification period.

12.What is an interim report?[Top]If you are certified for either twelve or twenty-four months for Food Assistance you will be required tocomplete a JFS 07221 "Cash and Food Assistance Interim Report". The completed interim report will give the county agency updated information on your circumstances. If this form is not signed and returned your benefits will be stopped.

13. When will I get my interim report and what do I need to do with it? [Top]If you are certified for twelve months:The interim report will be sent to you during the fifth month of certification, and you are required to return it before the end of the 21st day of the fifth month.

If you do not return a signed interim report by the twenty-first day of the fifth month of your certification period, the county agency will propose termination of your benefits.

If you are certified for twenty-four months:The interim report will be sent to you during the eleventh month of certification. You are required to return the interim report prior to the end of the twenty-first day of the eleventh month of certification.

If you do not return a signed interim report by the twenty-first day of the eleventh month of your certification period, the county agency will propose termination of your benefits.

Interim reports can be completed and submitted either online using "My Case" or a hard copy can be printed from the ODJFS Forms Central website. If you choose to complete your interim report by hard copy you must complete and sign the form and then mail, fax or take it to your local county agency.

14. What is a reapplication?[Top]A reapplication is a chance for the county agency to review and confirm that you continue to meet all of the eligibility requirements for the benefits you are currently receiving. The type of assistance you are receiving will determine how often you will be asked to complete a reapplication.

15.How will I know that a reapplication is needed for my benefits?[Top] You will be notified in writing by your local county agency when you are required to complete a reapplication for your case. A reapplication consists of 2 parts: 1. Signing the JFS 7204 “Request to Reapply for Cash and Food Assistance” and 2. Participating in an interview with your county agency either in person or by phone.

16. Do I need to be a U.S. Citizen to receive cash or food assistance? [Top] Certain non-citizens, such as those admitted for humanitarian reasons, those admitted for permanent residence, many children, elderly immigrants and individuals who have been working in the United States for certain periods of time, may be eligible. Eligible household members can get benefits even if there are other members of the household who are not eligible. You only have to indicate if someone is a U.S. citizen if they are applying for cash, food, or medical assistance.

17. Do I have to provide my social security number?[Top] You must provide the county agency with a social security number, or apply for a social security number, for each person applying to receive assistance. You may not need to give us information in all situations. The collection of this information is authorized under the Food and Nutrition Act of 2008, as amended, 7 U.S.C. 2011-2036, Section 1137(1) of the Act, 42 C.F.R., 435.910, and rules 5101:1-1-03 and 5101:1-3-09 of the Ohio Administrative Code.

18.I received a medical bill, how can I get it paid? [Top]If you have Ohio Medicaid and were covered on the date of service and it is a service that is covered by Medicaid, call the provider and give them your billing number and ask them to bill Medicaid. If you are on a Managed Care Plan, please call your Managed Care Plan for information on billing.

19. Will Medicaid cover past medical bills?[Top]If you have outstanding medical bills at the time you apply for Medicaid, you can apply for retroactive coverage, up to three months prior to the month of application. The county worker will determine the eligibility based on the income and resources for each of the three months prior to the application that you have verified medical expenses.

20. The pharmacy said my prescription requires a prior authorization – what is that?[Top]Prior authorization is the approval process used by Ohio Medicaid to determine the medical necessity for particular medications. Prior authorizations must come from the physician or provider who prescribed the medication. The provider calls ACS, the pharmacy contractor at 1-877-518-1546 to request prior authorization. A request for prior authorization does not guarantee approval.

21.What is Medicaid Buy- In for Workers with Disabilities?[Top]Medicaid Buy-In for Workers with Disabilities (MBIWD) is a program that can help people with disabilities work without losing Medicaid. If you are a resident of Ohio, meet citizenship requirements, are aged 16 to 64, receive SSI, Social Security Disability or Medicaid for the disabled and have income from employment you may be eligible to get Medicaid. Depending on your income, a monthly premium may apply. Your county department of job and family services will determine your eligibility for this program.

22. What is a premium?[Top]A monthly premium may be required for those eligible for MBIWD with an annual gross income greater than 150% of the federal poverty level. Premiums are determined through a set of calculations based on income, family size and certain standard deductions (e.g. health insurance premiums, impairment related - work expenses, etc.) ODJFS sends consumers enrolled in MBIWD, who owe a premium, an invoice each month with the monthly premium amount. Payments can be made by check, money order or cashiers check made payable to:

Treasurer, State of Ohio/ODJFSOhio Dept. of Job and Family ServicesP.O. Box 713067Cincinnati, Ohio 45271-3067

23. Can I get help with my Medicare expenses?[Top]There are Medicare Premium Assistance Programs that are designed to assist people on Medicare who have limited income and resources pay for some of their Medicare expenses. There are three programs with different income and eligibility requirements. All three programs pay the Medicare Part B premium. click here for Form JFS 07103 .

24. What is a spenddown?[Top] Consumers who are aged, blind or disabled may qualify for Medicaid after they have paid or incurred a specific amount of medical expenses in a given month. A spenddown is the amount the State determines you need to contribute towards your monthly medical expenses.

25. How do I meet my spenddown?[Top] There are three ways you can meet the spenddown requirement.1. You can incur medical expenses in an amount equal to or above your spenddown amount and give a copy of the documentation to your caseworker.2. You can pay out-of-pocket for medical expenses in an amount equal to or above your spenddown amount and give a copy of the information to your caseworker.3. You can pay the spenddown amount directly to your county job and family services office.

27. What is Healthchek?[Top] Healthchek is a comprehensive preventative health care, diagnosis and treatment services benefit. It is free to all children on Medicaid from birth to age 20. The purpose of Healthchek is to uncover and provide treatment for the physical, mental and developmental health needs of children through periodic screenings. If a medical problem is detected, Medicaid covers further diagnosis and treatment.

28. What is patient liability?[Top] Patient Liability is the financial amount that a recipient is responsible for contributing toward their long-term care prior to Medicaid assuming responsibility for the remainder of their care. Patient Liability is typically required for consumers who are living in a nursing home; however, it can apply to consumers receiving nursing care in their home or living in an intermediate care facility. The amount of a patient's liability is determined by income and standard deductions.

29. I just found out I am pregnant and need to get prenatal care right way. How long does it take to get Medicaid?[Top] Eligibility determination for most Medicaid programs takes approximately 30 days. However, pregnant women can get 60 days of limited medical coverage while their eligibility for full Medicaid is being determined. If you are eligible, you may have coverage within 24 hours of your application. To be eligible:- your family income must be under 200% of the federal poverty level; and - you have medical proof of pregnancy verified by a doctor or nurse. click here for Form JFS 07216.

30. What is Estate Recovery?[Top]Estate recovery is a program through the Office of the Attorney General that seeks repayment for the cost of Medicaid benefits of consumers who are aged 55 years and older or permanently institutionalized at the time of their death. Medicaid services provided after January 1, 1995 are subject to recovery. Medicare premium assistance payments made after January 1, 2010 are subject to recovery only if the consumer was permanently institutionalized.

31. How does Estate Recovery Work?[Top] An estate is real and personal property and all other assets owned (home, land, cars, etc.) by a Medicaid consumer. The executor of the estate is responsible for notifying the Office of the Attorney General of the death of a Medicaid consumer. The Attorney General will notify the executor if there is a claim for recovery.

32. Can I get any assistance with home health care from Medicaid? [Top]Medicaid consumers can receive up to 14 hours per week of combined nursing and home health aide services. Consumers should choose a home health agency that is both a Medicaid and Medicare Certified Home health agency. Click here for Form JFS 02399 if you need more than 14 hours of home health care.

33. Is there Medicaid available for consumers who are over age 18?[Top]There is a Medicaid program available for individuals who are between the ages 19 and 21. Eligibility is based on an individual's income and possibly their family's income if they still live at home with their parent(s). Medicaid for youths who are aging out of foster care may also be eligible depending on their age. click here for Form JFS 07216.

34. Does Medicaid share my personal information? [Top]Medicaid considers your health information to be private. Medicaid will not share your information for reasons other than treatment, payment of medical claims or health care operations. Medicaid may release information to help you get the services you need.

35. What is a Third Party Insurance? [Top]Third party insurance or liability is another medical insurance other than your Medicaid coverage. Medicaid is always the payer of last resort. Meaning, any medical insurance other than your Medicaid is primary. If you have had other medical insurance and it is not longer valid, you must inform your county department of job and family services. They will assist in removing this information.

36. I am not happy with my managed care plan; can I make a change to my plan? [Top]There are three times when you can change your managed care plan;1. During your initial 90 days of enrollment.2. During open enrollment month which is every November.3. After an approval of a Just Cause change request. Just Cause is an approved exception that allows you to change your managed care plan.

37. Are immigrants eligible for Medicaid?[Top]Eligibility for Medicaid depends on the date the immigrant arrived in the United States. If the immigrant arrived before August 22, 1996 Medicaid may be approved if the other eligibility guidelines are met (e.g. income). If the immigrant arrived after August 22, 1996 Medicaid cannot be provided for five years unless the applicant:- is a refugee- was granted asylum- is a victim of human trafficking- deportation is withheld- meets certain requirements as a Cuban or Haitian Immigrant- meets certain requirements as an Ameriasian from Vietnam- is a permanent resident who has worked 40 quarters under the Social Security Act- is a U.S. Veteran or active duty status (includes spouse and dependants)- has a "special immigrant visa", which is given to Afghani or Iraqi citizens who have helped the U.S. military